AAPD Reference Manual 2022-2023

ORAL HEALTH POLICIES: ORAL HEALTH CARE PROGRAMS

• For both total and untreated caries, prevalence decreased as family income level increased. • Untreated caries prevalence increased from 2011–2012 (16.1%) to 2013–2014 (18.0%) and then decreased in 2015–2016 (13.0%).” 25 Untreated caries among children two to eight years of age was shown to be twice as high for Hispanic and non-Hispanic African American children in comparison to non-Hispanic White children. 19 American Indian ( AI ) and Alaska Native ( AN ) children demonstrated a higher rate of caries than other population groups in the U.S., with approximately 40 percent of AI/AN children aged three through five years exhibiting untreated caries in contrast to only 11 percent of non-Hispanic White children. 21 HHS reports a perception that oral health is separate from general health and, therefore, less important. 3 By raising oral health awareness, the prevention, early detection, and man- agement of dental, oral, and craniofacial tissues can become integrated into general health care, community-based pro- grams, and social services. 3 HHS recognizes that oral health can have a significant impact on overall health and well-being. Major themes of the Oral Health in America: A Report of the Surgeon General 3 include: • “Oral health means much more than healthy teeth.” • “Oral health is integral to general health.” Oral health integration into the broader health care system is still viewed as a supplemental benefit, not a priority benefit. 26 This separate view of oral health negatively impacts our na- tion including the increasing use of emergency departments at substantial cost to treat dental pain and related conditions. 26 Accordingly, the HHS report National Call to Action to Promote Oral Health 27 included a partnership of public and private organizations that specified a vision, goals, and a series of actions to promote oral health, prevent disease, and reduce oral health disparities in vulnerable populations including the disadvantaged poor, racial and ethnic groups, individuals living in geographically isolated areas, and those with special oral health care needs. These actions are necessary and define cer- tain tasks to assure that all Americans of all ages and those individuals who require specialized health care services, inter- ventions, and programs achieve optimal oral health. The five principal actions and implementation strategies that constitute the Call to Action include: • “Action 1–Change Perceptions of Oral Health- Policymakers, community leaders, private industry, health professionals, the media, and the public are called upon to raise the level of awareness and understanding of oral health, affirming that oral health is essential to general health and well-being. • Action 2–Overcome Barriers by Replicating Effective Programs and Proven Efforts-Remove known barriers between people and oral health services by implementing

strategies to engage all groups to eliminate health dis- parities through health promotion and health literacy, improve access. • Action 3–Build the Science Base and Accelerate Science Transfer-Application of research findings to improve oral health. • Action 4–Increase Oral Health Workforce Diversity, Capacity, and Flexibility-Ensure the adequacy of public and private health personnel and resources to meet the oral health needs of all Americans and enable the inte gration of oral health effectively with general health. • Action 5–Increase Collaborations-Develop partnerships and utilize resources from social services, education, health care services at state and local levels, including commu- nity groups, voluntary organizations and individuals.” 27 The Call to Action urges that oral health promotion, dis ease prevention, and oral health care issues have a presence in all health policy agendas and are discussed at local, state, and national levels. 27 Its success relies on shared knowledge and its execution at all levels. 27 As follow-up to Oral Health in America 3 , the HHS Oral Health Initiative 2010 was developed. 28 The key statement from this initiative was, “Oral health is integral to overall health”. 28 Total health and wellness cannot exist without oral health. Oral disease can have an impact on physical, psycho- logical, social, and economic health and well-being through pain, diminished function, and reduced quality of life. 29 Through this initiative, programs were created, produced, and financed to: • emphasize oral health promotion and disease prevention. • increase access to care. The HHS created the U.S. Department of Health and Human Services Oral Health Strategic Framework, 2014-2017 (known as the Framework) which reflects deliberations and next steps proposed by HHS and other federal partners to support the department’s oral health vision and eliminate oral health disparities. 30 The Framework has five goals: “1. Integrate oral health and primary health care. 2. Prevent disease and promote oral health. 3. Increase access to oral health care and eliminate disparities. 4. Increase the dissemination of oral health information and improve health literacy. 5. Advance oral health in public policy and research.” 30 Federal agencies currently collaborate and through commu- nication processes ensure that comprehensive, updated, evidence-based health information is disseminated. 30 Govern- ment agencies and providers continue to engage, develop and implement solutions to improve overall health and well-being. 30 • enhance oral health workforce. • eliminate oral health disparities. 28

THE REFERENCE MANUAL OF PEDIATRIC DENTISTRY

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